1. Field of the Invention
This invention relates to articular cartilage repair generally and, more particularly, to a device and method for removing loose articular cartilage fragments during an arthroscopic procedure with a reduced risk of damage to healthy cartilage.
2. Description of the Prior Art
Diarthroses in the human body, freely movable joints, are distinguished by, among other things, the presence of articular cartilage on the surfaces of the articulating bones. The articular cartilage does not bind the bones together; instead, it acts to reduce friction when the bones move and helps to absorb shock. There are a number of different types of diarthroses, including gliding, hinge, pivot, condyloid, saddle, and ball and socket. The two major diarthroses are the knee and the shoulder joints.
With specific regard to the knee joint, the surfaces where the femur, tibia and patella touch are all covered with articular cartilage. As a result of excess stress on the joint, trauma, muscle weakness, or perhaps other factors, a fragment (or fragments) of articular cartilage may partially dislodge from the articular cartilage surfacexe2x80x94so that it extends into the joint cavity but is still partially attached to the cartilage surface. Such loose cartilage fragments can be sources of clicking, catching, or popping in the jointxe2x80x94and/or can cause pain, swelling or other mechanical irritation. While the knee joint is provided as an example, it should be understood that the problem of articular cartilage occurs in the shoulder and other diarthroses in the body as well.
Loose cartilage fragments can be removed during an arthroscopic surgical procedure. One prior art device for the removal of loose fragments is an arthroscopic surgery blade made by Smith and Nephew, Inc. The Smith and Nephew blade is a rotary vacuum shaver, having an external stationary tube having a sidefacing opening at its distal end, and an internal rotating blade. When the opening is brought in contact with the loose cartilage fragments, the rotating blade shears the fragment, which may then be suctioned through the instrument and out of the joint cavity.
One significant drawback to the Smith and Nephew device, however, is that during operation the blade can nick or cut healthy articular cartilage or can inadvertently remove healthy cartilage with the fragmentxe2x80x94undermining the healthy cartilage surface.
A need therefore existed for a device and method for removing articular cartilage fragments from a joint, with a reduced risk of undermining the healthy cartilage surface. The articular cartilage brush and method of the present invention provides these and other related advantages.
It is an object of this invention to provide an improved device and method for removing articular cartilage fragments from any body joint with a reduced risk of undermining the healthy cartilage surface.
It is a further object of this invention to provide an improved device and method for removing articular cartilage fragments from the knee joint with a reduced risk of undermining the healthy cartilage surface.
In accordance with one embodiment of the present invention, an improved cartilage fragment removal device is disclosed. The device comprises, in combination: a shaft having a proximal end and a distal end and dimensioned to be inserted into an incision of the size made for insertion of surgical instruments during arthroscopic surgery; a brush attachment having a plurality of bristles thereon coupled to the distal end of the shaft; and drive means coupled to a proximate end of the shaft for driving the brush attachment.
In accordance with a further embodiment of the present invention, a method for removing articular cartilage fragments comprising the steps of: providing a cartilage fragment removal device comprising: a shaft having a proximal end and a distal end and dimensioned to be inserted into an incision of the size made for insertion of surgical instruments during arthroscopic surgery; a brush attachment having a plurality of bristles thereon coupled to the distal end of the shaft; and drive means coupled to a proximate end of the shaft for driving the brush attachment; making an incision in a portion of a body for permitting access to an area having an articular cartilage fragment to be removed; inserting into the incision the brush attachment; driving the brush attachment; bringing the brush attachment in a driving condition into contact with the articular cartilage fragment to be removed until the articular cartilage fragment is detached; and removing the detached articular cartilage fragment from the body.